Visual outcome and its prognostic factors in patients presenting with ocular war injuries at an army hospital in Pakistan.

OBJECTIVE: To determine the visual outcome and its prognostic factors in patients presenting with ocular war injuries. METHODS: This descriptive, observational study was conducted at the Combined Military Hospital, Peshawar, Pakistan, from June 2012 to March 2016, and comprised soldiers with ocular war injuries. Informed consent was obtained from all participants. A predesigned proforma was used to record patient's demographic details along with the cause, side, type and severity of injury. Injuries were classified as open globe or closed globe injuries. Ocular trauma score grade was used to describe the severity of injury. RESULTS: There were 210 participants with an overall mean age of 29.34±5.35 years (range: 20-43 years). All of them were male. Left side was more frequently involved, i.e. in 126(60%) cases. The most frequent underlying cause was improvised explosive device blast injury 114(54.3%), followed by blunt trauma 42(20%) and road traffic accidents 24(11.4%). Closed globe injuries were more frequent and were recorded in 120(57.1%) patients. The visual outcome was good in 62(29.5%) patients, followed by fair in 51(24.3%) patients while 51(24.3%) patients had worst visual outcome. When stratified, there was no significant difference of worst visual outcome with patient's age (p=0.279). However, improvised explosive device blast (p=0.002), open globe injury (p=0.000), ocular trauma score grade 1; open globe (p=0.049), closed globe (p=0.003) were associated with significantly higher frequency of worst visual outcome. Zone-III injury was also prognostic of worst visual outcome, but the difference was significant only in case of open globe injury (p=0.003). CONCLUSIONS: Improvised explosive device blast, open globe injury and ocular trauma score grade 1 were poor prognostic features and resulted in significantly higher frequency of poor visual outcome.

Prevalence of myths concerning growth and health of children among females of local population of Pakistan.

OBJECTIVE: To analyse the prevalence of myths among women regarding growth and health-related issues of children, and to study the impact of basic demographic factors in this regard. METHODS: The educational, cross-sectional, descriptive study was carried out at the Combined Military Hospital, Peshawar, Pakistan, from January 2016 to January 2017. It comprised women reporting to paediatric outpatient clinics, and the subjects were selected using convenience sampling. A self-designed questionnaire was used which contained demographic details and 15 closed-ended questions encompassing common myths concerning child health-related issues. Total answers given by a client as YES (beliefs in myths) were grouped as >50% YES or <50% YES; and was cross-tabulated with independent variables. SPSS21was used for statistical analysis. RESULTS: Of the 422 subjects, 301(71.3%) believed in the existence of 'Garam' foods. Overall, 278(65.9%) subjects had <50% YES, and 144(34.1%) had >50% YES answers. Three most commonly believed myths were: a neonate must be tied for better growth 281(66.6%), 'Garam' food should not be given to children in summers 225(53.3%), and diseases like 'Kala Yarqaan' are transmitted through lactation 223(52.8%). There was a significant impact of education (p<0.001) and regional background (p=0.006) on predilection for harbouring myths. There was no significant impact of age (p=0.415), marital status (p=0.790) or socio-economic class (p=0.196) on the matter. CONCLUSIONS: Significant prevalence of myths pertinent to children's health-related issues among ladies was observed. The lacunae identified must be aptly addressed at clinical level as well as via lectures and seminars.

Reproductive health issues in Pakistan; do myths take precedence over medical evidence?

OBJECTIVE: To analyse the prevalence of myths pertinent to healthcare issues of females of reproductive age. METHODS: This cross-sectional, simple descriptive, knowledge, attitude and practices-education research was conducted at the Combined Military Hospital, Peshawar, Pakistan, from February to August 2016. A 30-item self-designed questionnaire was applied, collecting demographic details and answers to 21 close-ended questions encompassing the prevalence of myths pertinent to reproductive health issues of women in Pakistan.Every question had three options, Yes(myth), No(correct answer) and Don't Know(unsure). SPSS 21 was used for data analysis. RESULTS: There were 594 participants in the study. The overall mean age was 35.11±12.711 years and the mean duration of education was 9.41±6.353 years. Besides, >50% answers positive for myths and <50% answers positive for myths were given by 326(54.9%) and 268(45.1%) respondents, respectively. The prevalence of myths was directly proportional to age (p=0.004), and inversely proportional to education (p<0.001) and socio-economic class(p<0.001); impact of education was stronger than socio-economic class(Pearson's chi-square being 74.189 and 48.672, respectively). Khyber Pakhtunkhwa-based respondents harboured more myths (p=0.024). There was no significant impact of marital status (p=0.099). CONCLUSIONS: The participants held significant amount of myths regarding health issues in reproductive age.

Etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan.

OBJECTIVE: To determine the etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan. METHODS: This cross sectional study was conducted at the Department of Ophthalmology, Combined Military Hospital, Peshawar over four years period from June 2012 through March 2016, Two hundred ten consecutive soldiers who presented with ocular war injuries were included for analysis after taking written informed consent. A predesigned proforma was used to record patient's demographic details along with the cause, side, type and severity of injury, ocular trauma score was also recorded at presentation. RESULTS: The mean age of the patients was 29.34±5.35 years. All of them were males. Left side was more frequently involved (n=126, 60.0%) and the most frequent underlying cause was IED blast injury (n=114, 54.3%). Closed globe injuries were more frequent and were recorded in 120 (57.1%) patients. Upon assigning Ocular Trauma Score, Grade-V (28.6%) injuries were the most frequent followed by Grade-I (25.7%), Grade III (25.7%), Grade II (11.4%) and Grade IV (8.6%). When stratified for the type of injury, OTS Grade I injuries were highest (60.0%) among patients with open globe injuries, hence poorer prognosis, while OTS Grade V injuries were highest (50.0%) among patients with closed globe injuries (p=0.000). CONCLUSION: IED blast injuries are most frequently encountered ocular war injuries often involving soldiers in the age group 20-30 years. These open globe injuries had worst clinical presentation to begin with and poorer prognosis than closed globe injuries.